From mosquitoes to menace: Unveiling the dangers of West Nile virus in Pakistan.

Pakistan, a subtropical nation, has seen a rapid rise in Arboviral transmission in the past decade. Environmental hazards such as intense monsoon rains and yearly floods in addition to unsanitary living conditions pose an increased risk of arboviral infections. In recent years, the emergence and spread of West Nile virus (WNV), which can lead to a life-threatening meningoencephalitis, in Pakistan has alarmed the health care authorities of an impending outbreak. Health professionals and policymakers should give paramount importance to prevent its transmission across Pakistan as another arboviral outbreak would wreak havoc on the already fragile health infrastructure of the country. Proactive surveillance and prompt reporting are crucial for mitigating this threat as there are no vaccines available to prevent WNV infection.

Daptomycin MICs by Broth Microdilution Method Against Staphylococcus aureus in Clinical Specimens: A Cross-Sectional Study from Pakistan.

OBJECTIVE: To explore the distribution of daptomycin (DAP) minimum inhibitory concentrations (MICs) in Staphylococcus aureus isolated from complicated skin, soft tissue, and bloodstream infections collected from the Pakistani population using broth microdilution (BMD). STUDY DESIGN: Descriptive, cross-sectional study. Place and Duration of the Study: Department of Pathology and Laboratory Medicine, The Aga Khan University Hospital, from May to October 2021. METHODOLOGY: Through consecutive sampling techniques, 169 Staphylococcus aureus (S. aureus) isolated from clinical specimens including pus, tissue, and blood were collected. Patients' data including age, gender, geographical location, specimen site, and methicillin susceptibility were collected from the laboratory data. BMD was used to determine MICs of clinical isolates and S. aureus ATCC 29213. DAP MIC ≤1.0 µg/ml was considered susceptible according to the Clinical and Laboratory Standards Institute M100. RESULTS: Among all the clinical isolates, 144 (85%) and 25 (15%) were from skin and soft tissue and blood, respectively. All isolates were susceptible to DAP with MIC50, MIC90, and MIC range of 0.25 µg/ml, 0.5 µg/ml, and 0.06 - 0.5 µg/ml, respectively. CONCLUSION: These study findings demonstrated low in-vitro MICs for DAP against S. aureus in tested isolates from a diverse variety of patient specimens from across Pakistan. KEY WORDS: Daptomycin, Staphylococcus aureus, Broth microdilution, Minimum inhibitory concentrations.

Patient's Knowledge and Perception of Endodontics Treatment: An Observational Study.

Objective: To assess public awareness regarding endodontic treatment and assess patients' knowledge regarding endodontic treatment. Materials and Methods: A questionnaire was prepared and given to 300 patients who had visited the Department of Conservative Dentistry and Endodontics between November 2021 and October 2022, after obtaining ethical clearance and consent from all the participants. The questionnaire included sociodemographic details and about their knowledge about endodontic treatment. The collected data were tabulated and analyzed. Statistical Analysis: Data analysis was performed using methods of descriptive statistics like frequency and percentages. Results: We found that most of the respondents had an average level of knowledge regarding endodontic treatment. Conclusion: We observed an improvement in knowledge and perception regarding endodontic treatment.

The Response of Pakistani Social Workers amid the COVID-19 Pandemic: A Qualitative Analysis of the Main Challenges

The study aimed to highlight the main challenges faced by the social workers amid the pandemic. A qualitative study was conducted between March 2020 to May 2020 in Karachi, Pakistan. All participants who belonged to a non-profit organization were eligible to participate. Open-ended questions were asked by the participants. The mean age of the participants was 24.8 {+/-} 5.9 years. The main challenges faced by the social workers were: i) resistance from the family and friends, ii) lack of personal protective equipment, iii) mistrust from public, iv) uncooperative government/authorities.

Can human maxillary premolars discriminate between sexes in South Asian populations? / ¿Pueden los premolares maxilares humanos discriminar entre sexos en las poblaciones del sur de Asia?

The studies have illustrated odontometric analysis can be used to determine the sexual dimorphism effect on size of the teeth in various populations. The main aim of the study was to identify the inter-cuspal-, bucco-lingual -dimensions and weight of human upper-arch pre-molars in males and females of different South Asian populations. These metrics can distinguish sex which can have application in mass disasters, archaeology of mingled human remains and the in unidentified or several ancestry. The sample size consisted of 60 orthodontically extracted maxillary pre-molars from Pakistani and Saudi Arabian populations respectively. For male and female groups of each population fifteen first and second maxillary premolars were collected respectively, stored in PBS solution. The weight of the individual teeth was recorded. Later, digitally pictures were captured parallel to the occlusal surface to measure maximal bucco-lingual and inter-cuspal dimensions using Image-J software. The dimensions and weights were compared using Students' t-test between males and females respective Pakistani and Saudi Arabian first (P1) and second (P2) maxillary pre-molars. The dimensions for male P1 and P2 were statistically significantly larger than that for females in both populations. Furthermore, wet-weight of pre-molars in males is significantly greater than females in both populations. The findings demonstrate maxillary pre-molars can discriminate between the sexes in various populations.

Las investigaciones han ilustrado que el análisis odontométrico se puede utilizar para determinar el efecto del dimorfismo sexual en el tamaño de los dientes en varias poblaciones. El objetivo principal del estudio fue identificar las dimensiones y el peso entre cúspides, buco-linguales y el peso de los premolares de la arcada superior humana en hombres y mujeres de diferentes poblaciones del sur de Asia. Estas medidas pueden distinguir el sexo y ser importante en desastres masivos, arqueología de restos humanos entremezclados y en ancestros no identificados. El tamaño de la muestra consistió en 60 premolares maxilares extraídos ortodóncicamente de las poblaciones de Pakistán y Arabia Saudita, respectivamente. Para los grupos de hombres y mujeres de cada población, se recogieron quince primeros y segundos premolares superiores respectivamente, almacenados en solución de PBS. Se registró el peso de los dientes individuales. Posteriormente se capturaron imágenes digitales paralelas a la superficie oclusal para medir las dimensiones máximas buco-linguales e intercúspides utilizando software Image-J. Las dimensiones y los pesos se compararon mediante la prueba t de Student entre lo premolares maxilares (P1) y segundos (P2) de hombres y mujeres paquistaníes y saudíes. Las dimensiones para P1 y P2 de los hombres fueron estadísticamente significativos mayores que para las mujeres en ambas poblaciones. Además, el peso húmedo de los premolares en los varones era significativamente mayor que el de las mujeres en ambas poblaciones. Los hallazgos demuestran que los premolares maxilares pueden discriminar entre los sexos en varias poblaciones.

Residual root dentin thickness for three different rotary systems: A comparative cone beam computed tomography in vitro study.

BACKGROUND: Residual root dentin thickness (RDT) in endodontically treated teeth is a major factor that is responsible for longevity of treated tooth. AIMS AND OBJECTIVES: To evaluate and compare the amount of RDT during endodontic treatment using manual K-files and rotary Mtwo, ProTaper Next, and Hero shaper instruments. SETTINGS AND DESIGN: Anin vitro study was carried out on a sample of 100 freshly extracted human single straight rooted mandibular first premolar teeth. METHODOLOGY: The teeth were divided into five groups of twenty each and mounted on wax rims for a preoperative cone beam computed tomography scan to calculate the dentin thickness 3 and 6 mm from the apex. All the teeth were treated according to their groups. STATISTICAL ANALYSIS: The observations were then statistically analyzed using one-way ANOVA to evaluate the difference among four groups followed by post hoc test for pairwise comparison. RESULTS: Maximum preservation of dentin was seen in Group V (cleaning and shaping done with rotary Hero shaper files) at 3 and 6 mm from the apex, whereas minimum preservation of dentin was seen in Group IV at 3 mm (cleaning and shaping done with rotary ProTaper Next files) and Group II at 6 mm (cleaning and shaping done with hand K-stainless steel files) from the apex. Overall there was a statistically significant difference in RDT values between Group V and Groups I, II, III, IV both at 3 and 6 mm from the apex. CONCLUSION: Cleaning and shaping with rotary Hero shaper files preserved more amount of dentin when compared to hand K-files, rotary Mtwo, ProTaper Next.

Evaluation of Mineral Trioxide Aggregate, Resin-modified Glass lonomer Cements, and Composite as a Coronal Barrier: An in vitro Microbiological Study.

AIM: The purpose of the study is to evaluate the bacterial micro-leakage of three different materials, mineral trioxide aggregate (MTA), resin-modified glass ionomer cement (RMGIC), and flowable composite, as a coronal barrier against Enterococcus faecalis. MATERIALS AND METHODS: A total of 100 human extracted single-rooted teeth were selected. Access opening done, working length determined, and canals were cleaned and shaped with ProTaper F3 and obturated with AH26 and gutta-percha (GP) using lateral condensation technique. Samples were divided into three experimental and two control groups. Approximately 3 mm GP was removed from the coronal orifice and restored with one of the test materials. Teeth were suspended in glass tubes containing brain heart infusion (BHI) broth and equipped with microcaps, which were used to check bacterial leakage. A 24-hour broth of E. faecalis was placed in the pulp chamber. Tubes were incubated and checked for turbidity for 90 days. Data were analyzed using chi-squared test between the test and control groups and Fisher test between the test groups. RESULTS: Significantly lesser number of samples turned turbid in the RMGIC group followed by MTA group and the maximum number of samples turned turbid in the flowable composite group. CONCLUSION: The RMGIC is a better coronal sealer, followed by MTA and flowable composite. CLINICAL SIGNIFICANCE: Coronal sealing ability of RMGIC is more promising in comparison with the other agents.

Fall Detection System for the Elderly Based on the Classification of Shimmer Sensor Prototype Data / 대한의료정보학회지

OBJECTIVES: Falling in the elderly is considered a major cause of death. In recent years, ambient and wireless sensor platforms have been extensively used in developed countries for the detection of falls in the elderly. However, we believe extra efforts are required to address this issue in developing countries, such as Pakistan, where most deaths due to falls are not even reported. Considering this, in this paper, we propose a fall detection system prototype that s based on the classification on real time shimmer sensor data. METHODS: We first developed a data set, ‘SMotion’ of certain postures that could lead to falls in the elderly by using a body area network of Shimmer sensors and categorized the items in this data set into age and weight groups. We developed a feature selection and classification system using three classifiers, namely, support vector machine (SVM), K-nearest neighbor (KNN), and neural network (NN). Finally, a prototype was fabricated to generate alerts to caregivers, health experts, or emergency services in case of fall. RESULTS: To evaluate the proposed system, SVM, KNN, and NN were used. The results of this study identified KNN as the most accurate classifier with maximum accuracy of 96% for age groups and 93% for weight groups. CONCLUSIONS: In this paper, a classification-based fall detection system is proposed. For this purpose, the SMotion data set was developed and categorized into two groups (age and weight groups). The proposed fall detection system for the elderly is implemented through a body area sensor network using third-generation sensors. The evaluation results demonstrate the reasonable performance of the proposed fall detection prototype system in the tested scenarios.

Human papilloma virus--role in precancerous and cancerous oral lesions of tobacco chewers.

Human papilloma viruses (HPV), members of the papillomaviridae family, infects squamous epithelial cells of cevix, lower genitalia, and oral cavity. The association of HPV with oropharyngeal carcinogenesis is well documented.The incidence of oral cancer ranks second in Karachi South in both genders according to World Health Organization (WHO) statistics. This is attributed to the popularity of chewable tobacco products among the general population. Studies on Gutka-eaters in a set population of Karachi showed high frequency of HPV (17%) and high prevalence of HPV in squamous cell carcinoma in Pakistani patients (68%). The exposure of oral mucosa to chewable tobacco causes abrasions making it susceptible to HPV. This review strives to summarise the role of HPV in chewable tobacco-related precancerous and cancerous lesions. The literature of about a decade was retrieved from Google and pubMed with the under mentioned key words. It was found that the use of chewable tobacco products, especially Gutka, may increase the risk of oral squamous cell carcinoma (OSCC).